Health
Why are people with intellectual disabilities clinically vulnerable to COVID-19?
A growing body of research shows that people with intellectual disabilities are more likely to die from COVID-19 during the first two years of the pandemic. To put these figures into context, about 600 more people with intellectual disabilities died in the Netherlands than would have been expected given the mortality rates of the rest of the population. Cuypers et al. also showed that this mortality gap existed before the pandemic and that non-COVID causes of death among people with intellectual disabilities rose during the pandemic. Other data sources indicate that her adverse effects of COVID-19 on people with intellectual disabilities exceeded the risk of death. For example, qualitative research highlights the isolation, loneliness, and loss of self-esteem experienced by people with intellectual disabilities during the COVID-19 pandemic.
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Families and caregivers were also exposed to a heavy burden.
A key question is why the impact of COVID-19 was greater for people with intellectual disabilities. More fundamentally, why was this group clinically vulnerable?
Due to the high prevalence of other risk factors such as obesity and diabetes, other individuals with intellectual disabilities may be at increased risk of death from COVID-19.
However, we must also recognize discriminatory and exclusionary social structures that create clinical vulnerabilities for people with disabilities, especially those with intellectual disabilities. Inaccessible health facilities and information, lack of social care, lack of protective measures in nursing homes, inadequately trained medical staff, and delays in prioritizing vaccines all put people with intellectual disabilities at risk. It’s what made him clinically vulnerable to COVID-19. People with intellectual disabilities have been neglected and forgotten in government responses to pandemics around the world, especially in the early stages.
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They became clinically vulnerable, in part through neglect.
These shortcomings include social inequalities for people with disabilities, such as poor access to health care, education and employment, poverty and increased risk of violence and abuse.
These social inequalities further exacerbate the clinical vulnerability of people with intellectual disabilities to health problems, including mental disorders. While we should not place the burden of clinical vulnerability (and broader morbidity and mortality) to COVID-19 on individuals with intellectual disabilities, our societies, policies, and Should be owed to failure of service.
Highlight and address health risks. Evidence that people with intellectual disabilities are more likely to die from COVID-19 has made vaccination a priority in many countries, including the UK.
As another example, the 2013 UK Confidential Inquiry showed that people with intellectual disabilities die 13 to 20 years earlier than people without disabilities. This is often due to the failure of the healthcare system.
As a result, the UK National Health Service has taken steps to fill this gap, including mandatory training of health workers on intellectual disabilities, establishment of a learning disability registry, invitations for regular medical examinations and regular monitoring of health. Introduced various services. Gaps from the Learning Disability Mortality Review.
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Significant progress is still needed, but we need to draw inspiration from these concrete examples of how evidence can be transformative. As people with disabilities need to be at the center of health care planning and delivery, participation in health care needs to become a priority and a right rather than a desire. Do not assume that addressing these issues is too expensive or too complex. There is a growing range of good practices that show how inclusive health systems can be built and that they are likely to reduce costs and work more effectively for all.
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In the words of the recently deceased disability rights activist Judy Human, “Assuming problems can be solved, most things are possible.”
We declare no competing interests.
References
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All-cause and cause-specific mortality in persons with and without intellectual disability during the COVID-19 pandemic in the Netherlands: a population-based cohort study.
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“Have they thought of people like us?”: The experiences of people with learning disabilities in England and Scotland during the COVID-19 pandemic.
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Long-term social restrictions and lack of work activity during the COVID-19 pandemic: Impact on daily life of people with intellectual disabilities.
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Impact of the COVID-19 pandemic on caregivers of people with intellectual disabilities compared to caregivers of people with other disabilities and mental health problems: a multinational study.
Int J Environmental Resolution Public Health. 2023; 20: 1-14
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Risk of COVID-19 hospitalization and death in people with learning disabilities: a population-based cohort study using the OpenSAFELY platform.
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Prevalence and incidence of physical health conditions in people with intellectual disabilities – a systematic review.
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Health inequalities and people with learning disabilities in the UK.
Tizard Learn Disabil Rev. 2011; 16: 42-48
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2021 Learning Disabled and Autistic (LeDeR) Report.
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Learning from Life and Death—Persons with Learning Disabilities and Autism (LeDeR): Actions from Learning Reports 2021/22.
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Publication date: April 16, 2023
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